1. Home
  2. Directory
  3. Mississippi
  4. Wiggins
  5. Nurse Practitioner
  6. NPI Profile

KENDRA IESHA SAMUEL FNP
NPI 1386125383
Nurse Practitioner - Family in Wiggins, MS

Active since August 27, 2018PECOS EnrolledAccepts Medicare Assignment
1434 CENTRAL AVE E, WIGGINS, MS 39577(601) 928-6600 Get Directions Write a Review

NPPES record last updated: October 22, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 22, 2020, Jan 11, 2019, Aug 27, 2018 (3 updates tracked since 2018).

About Kendra Iesha Samuel Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENDRA IESHA SAMUEL FNP (NPI 1386125383) is an individual family provider in Wiggins, Mississippi, licensed in Mississippi (902802) and active in the NPI registry since August 2018. She is enrolled in Medicare PECOS, is affiliated with Memorial Hospital At Gulfport, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1386125383
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameKENDRA IESHA SAMUELCredential: FNP
Location Address1434 CENTRAL AVE EWiggins, MS 39577-9602
Mailing Address1434 Central Ave EWiggins, MS 39577-9602 · (601) 928-6600
Phone(601) 928-6600
Sole ProprietorYes
Medical School CMSOtherGraduated 2018
Enumeration DateAugust 27, 2018
Last NPPES UpdateOctober 22, 20203 updates tracked since enumeration
NPPES CertifiedOctober 22, 2020
✔ NPI 1386125383 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in MS · 902802
1434 CENTRAL AVE E, Wiggins, MS 39577
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Alabama.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kendra Iesha Samuel Fnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5395086904
PECOS Enrollment IDI20190426002348
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
458 services75 patients
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
164 services55 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Memorial Hospital At Gulfport

Acute Care Hospitals · Gulfport, MS
2/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number250019
Location4500 13th StreetGulfport, MS 39502 · Harrison County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39577 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$80.50 typical visit price
range $51.65 – $159.18
Typical copayment $20.12 (range $12.91 – $39.79)
Most-billed visit code 99203
Established Patient
$92.20 typical visit price
range $16.15 – $129.61
Typical copayment $23.05 (range $4.03 – $32.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Standard wheelchair K0001
DME-Wheelchairs · category DD000N
3 suppliers19 claims19 services$19.24 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STONE COUNTY HOSPITAL, INC
Ambulance
1434 CENTRAL AVE E
WIGGINS, MS 39577
Stone County (601) 928-6600
JAMES JASON ROGERS NP
Nurse Practitioner
1434 CENTRAL AVE E
WIGGINS, MS 39577
Stone County (601) 928-6600
STONE COUNTY HOSPITAL, INC
Medicare Defined Swing Bed Unit
1434 CENTRAL AVE E, P O DRAWER 97
WIGGINS, MS 39577
Stone County (601) 928-6600
HANNAH LEIGH FORE NP
Nurse Practitioner (Gerontology)
1434 CENTRAL AVE E
WIGGINS, MS 39577
Stone County (601) 928-6600
DR. WILLIAM BRYAN GIBBONEY DNP, FNP-C, ACNP-BC
Nurse Practitioner (Family)
1434 CENTRAL AVE E
WIGGINS, MS 39577
Stone County (228) 436-1191
LA'TORIA EVANS LPTA
Physical Therapy Assistant
1434 CENTRAL AVE E
WIGGINS, MS 39577
Stone County (601) 928-1889
DR. RENITA TA'SHA SHAW DPM
Podiatrist (Foot Surgery)
1434 CENTRAL AVE E
WIGGINS, MS 39577
Stone County (601) 928-6700
STONE COUNTY HOSPITAL, INC.
General Acute Care Hospital (Critical Access)
1434 CENTRAL AVE E, P O DRAWER 97
WIGGINS, MS 39577
Stone County (601) 928-6600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kendra Samuel's NPI number?

The NPI number for Kendra Samuel is 1386125383. It was assigned to this individual provider in the NPPES registry on August 27, 2018.

Where is Kendra Samuel located?

Kendra Samuel practices at 1434 Central Ave E, Wiggins, MS 39577. The listed phone number is (601) 928-6600.

What is Kendra Samuel's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Kendra Samuel enrolled in Medicare?

Yes. Kendra Samuel is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Kendra Samuel accept?

Health plans from Blue Cross and Blue Shield of Alabama list Kendra Samuel as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Kendra Samuel affiliated with any hospitals?

According to CMS data, Kendra Samuel is affiliated with Memorial Hospital At Gulfport.

When was this NPI record last updated?

The NPPES record for Kendra Samuel was last updated on October 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.